Gpsc Form 200-1 - Payphone Service Provider Registration September 2007 Page 2

LOCATION OF PAYPHONES:

PHONE

NUMBER

LOCALE

STREET

CITY

LEC

NOTE: In accordance with Rule 515-12-1-.31(1)(s), all PSPs shall provide to the Commission a list of all

payphone access lines maintained in the State of Georgia. Such information may be filed under the Trade

Secret provisions of this Commission. The first list is due thirty (30) days from the date the Commission

approves the PSP’s registration. Thereafter, the list shall be updated annually with such update being due on or

before January 31 of each year.

All PSPs are also required to state under oath the total number of payphones currently deployed within the State

of Georgia. Such information shall not be filed under the Trade Secret provisions of this Commission. This

total shall be updated annually with such update being due on or before January 31 of each year.

GPSC FORM 200-1, Revised: 09/11/07

Electronic Version

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